June 20, 2022 Senate Health and Human Services Committee

June 20, 2022

Senate Health and Human Services Committee Hearing June 21, 2022

Credentia is fully committed to meeting the needs of the Pennsylvania Nurse Aide testing community and

has been working closely with the Pennsylvania Department of Health and associated agencies in addition to

the Governor’s office to address the full scope of nurse aide testing including the current exceptional demand

for temporary nurse aide testing.

The Nursing Home Reform Act from the Omnibus Budget Reconciliation Act (OBRA) of 1987 required states

to have a nurse aide training and competency evaluation and nurse aide registry in operation by January 1,

1990. Credentia contracts with the DOH in administration of the registry and works the OLTL regarding the

requirements for testing providing the National Council State Boards of Nursing NNAAP® (National Nurse

Aide Assessment Program) examinations. The NNAAP® consists of a written/oral exam and a clinical skills

exam. As the sole vendor approved to provide the NNAAP ® Credentia’s only focus is on nurse aide testing

and registration. A weekly meeting is held with DOH, Bureau of Facility Licensure and Certification, OLTL,

HHS, PDE to address nurse aide testing in the Commonwealth.

In January of 2022 Credentia implemented an electronic registration, scheduling, and reporting system to

replace legacy systems. As part of this transition Credentia also implemented an on-line written/oral nurse

aide exam making this exam available for all PA nurse aide candidates, supplementing the paper-pencil

testing modality. The on-line exam allows candidates to test any time of day on a personal computer greatly

impacting the immediate availability of written testing for PA candidates. Due to this enhancement, there

are no shortages of written testing in the Commonwealth. Candidates can take this exam within 24 hours of

scheduling. The improved testing registration system and online modality occurred with no increase in

candidate fees.

As of June 20, 2022, there are twenty-one (21) Regional Testing Sites (RTS) contracted with Credentia and

ninety-seven (97) Infacility Testing Sites (INF). The testing sites provide testing events for the clinical skills

part of the examination in addition to paper-pencil written/oral exams if needed. The increase in RTS is

directly due to the outreach Credentia has made to employer and training program sites to increase testing

capacity for the TNA population. The effort to accommodate the increased testing needs with additional

testing facilities occurred without requiring a change to the contract or an increase in candidate fees.

Credentia continually recruits additional nurse aide evaluators for skills testing. Due to the extraordinary

challenges presented by the highly competitive post pandemic hiring market Credentia has made significant

investments into hiring an external RN recruiting firm to supplement the internal evaluator onboarding team.

The combined efforts of the recruiting firm and the internal onboarding team are showing successful results

attracting RNs to the evaluator positions, but we are still experiencing intense wage competition for RNs and

have implemented event bonuses on top of salary increases to attract RNs to testing events in all areas.

Credentia’s investments into recruiting, event coverage and onboarding support have not impacted

candidate fees.

The impact of the pandemic on testing availability and the addition of the TNA population has presented

significant challenges to the system. The pandemic shutdown NNAAP® testing for five months in which

testing sites were closed and RN evaluators were not allowed to evaluate. During this time testing sites and

evaluators were lost. Credentia has been successful in gaining back testing sites and continues to hire

additional evaluators, but the impact of the pandemic continues to have an effect on testing through the

increased demand of the TNAs and CNAs, CDC protocol for isolation/quarantine, and RN evaluator pay.

Working with the Governor’s office Credentia has held webinars addressing TNA employers; provided

additional training materials to assist TNAs in taking and passing the NNAAP exams; and created, distributed,

and analyzed an ongoing state-wide survey addressing the demand for TNA testing. Credentia continues to

invest in the Pennsylvania NNAAP testing program and work in partnership with all stakeholders to address

the current TNA timeline and the impact on CNA testing in the Commonwealth.

Sincerely,

Jennifer Mankowski, BSN, RN

Executive Vice President

Program Management and Development, Credentia